Seeing Beyond 20/20: How Vision Therapy Supports Neurodivergent and Aging Drivers

At Fitness to Drive, we know that driving is more than just getting from point A to point B—it’s about independence, participation in the community, and confidence on the road. For neurodivergent individuals and aging drivers alike, achieving this independence safely can be supported by understanding an often-overlooked part of the driving equation: vision beyond eyesight.

Why a Developmental Eye Exam Matters—Especially for Neurodivergent Drivers

When neurodivergent individuals—such as those with Autism Spectrum Disorder (ASD), ADHD, or learning disabilities—begin to explore learning to drive, most families and educators focus on driving instruction, traffic rules, and vehicle operation. However, vision problems often remain hidden. They can be missed by standard school vision screenings, routine physicals, or even regular eye exams that focus primarily on eye health and visual acuity.

Yet, research shows that people with ASD can experience visual motion processing differences, difficulties with spatial awareness, and atypical gaze patterns (Coulter, 2009; Reynolds et al., 2023).

These challenges may manifest as:

• Anxiety around fast-moving traffic

• Hyperfixation on specific objects, reducing awareness of surroundings

• Difficulty with depth perception and timing for lane changes or turns

• Over-reliance on tactile input in unfamiliar settings

  
  

Other neurodivergent drivers may also experience symptoms such as eye strain, headaches, poor visual memory, or challenges with left-right discrimination—all of which can complicate the learning-to-drive process.

Vision Therapy: Addressing More Than Just Clear Sight

Traditional eye exams by optometrists or ophthalmologists are essential for assessing eye health and prescribing lenses. But strong driving vision requires more than 20/20 acuity.

Visual skills critical for driving include:

• Eye teaming (binocular vision)

• Tracking moving objects smoothly

• Focusing quickly between near and far targets

• Visual-motor integration and spatial orientation

Behavioral or developmental optometrists (sometimes called functional or neuro-optometrists) specialize in assessing and improving how the eyes and brain work together. Through individualized vision therapy, these professionals help build skills that support safe driving.

Vision therapy is:

• Supervised, structured, and personalized

• Conducted by a vision therapist or occupational therapist under the doctor’s guidance

• Safe, drug-free, and effective for children and adults

Visual skills are learned early in life, but the good news is that neuroplasticity allows improvement at any age.

Benefits for Aging Drivers, Too

As we age, normal changes in vision—such as reduced contrast sensitivity, slower visual processing speed, and difficulty with glare—can affect driving confidence and safety. In addition, untreated vision deficits after a stroke or brain injury can be a hurdle for getting back to driving .

A comprehensive developmental eye exam and vision therapy can:

• Improve visual attention and scanning strategies

• Enhance depth perception

• Support faster visual reaction times

• Increase overall driving comfort and reduce fatigue

  
  

These interventions help aging drivers stay active and independent longer.

Driving: A Visually Complex Task

Driving requires the seamless integration of visual information with motor responses and cognitive processing. The clearer and more efficiently the brain processes visual input, the better a driver can anticipate hazards, judge distances, and make quick, safe decisions.

That’s why a developmental eye exam—and vision therapy when needed—can be a critical support for new neurodivergent drivers and aging drivers alike.

Want to Learn More?

If you or someone you care about is preparing to drive or returning to driving after a medical event, consider adding a comprehensive developmental eye exam to your checklist. To find a behavioral optometrist or neuro-optometrist, visit:

• College of Optometrists in Vision Development (COVD)

• Neuro-Optometric Rehabilitation Association (NORA)

At Fitness to Drive, we’re committed to supporting every driver’s unique journey—because safe driving isn’t just about seeing clearly, but seeing completely.